Covid-19 mass testing programme to be reviewed as disease comes under control

The future of the State’s Covid-19 mass testing programme is to be reviewed as the disease comes under control after the Government was told that “negative impacts” of testing are likely to become “disproportionate to the benefits to human health”.

In his latest letter to Minister for Health Stephen Donnelly, the State's chief medical officer Dr Tony Holohan wrote that it is important to plan for a "transition from open access or mass scale" testing as the harm from the virus "declines".

As this happens he wrote that “the negative impacts of testing at the current scale are likely to become disproportionate to the benefits to human health”.

The Department of Health did not immediately respond to a request to clarify what was meant by "negative impacts".

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Dr Holohan wrote that changes in the testing process had to be planned alongside overall changes in the public health response to Covid-19, which is due to undergo its most substantial redesign since the start of the pandemic as the Government shifts to a regime based on personal responsibility rather than laws and regulations.

“This will require a review of the public health response to Covid-19, to include testing, contract tracing, outbreak management, surveillance and sequencing,” he said. The review is to inform a plan that will focus on a “robust and rapid response to local and regional outbreaks”.

The plan will also be expected to address “surge response” to new variants of concern. “The HSE has commenced this process and will finalise its strategy for autumn/winter 2021/22 to ensure implementation at the point at which the criteria to transition are fulfilled.”

However, the HSE’s head of testing and tracing, Niamh O’Beirne, said there were no plans to scale down testing, which was being maintained in line with current Government policy.

“We have been given a clear direction from Government to retain all our capacity, not to downscale, and keep it all in place. That’s what we’re operating off,” she said.

“We’re still in a pandemic, we’re at 2,000 cases a day, opening up schools and colleges. We’re in the space, from a HSE perspective, of maintaining our testing and tracing across the pathway.”

GP practices

She said when diseases become endemic, such as the flu, testing was generally confined to certain GP practices which were part of what was termed a “sentinel” network, set up to try and assess the prevalence of a certain disease in the community rather than trying to track down every case of infection.

The testing system is currently under pressure due to the high level of infection in the community, with the highest level of community swabbing so far in this wave recorded on Monday of this week, when some 16,000 swabs were taken.

Ms O’Beirne said, however, that the system was coping, partially helped by the fact that vaccinated close contacts of confirmed cases were no longer referred for testing.

If faced with an overwhelming demand, the HSE has said it will switch to antigen testing for close contacts to free up capacity in the “gold standard” PCR testing system, as well as prioritising testing to certain vulnerable groups if needed.